When Dialysis Fistulas Fail: A New Treatment Option

Angioplasty with paclitaxel-eluting balloons leads to improved 6-month primary patency for patients with stenosed arteriovenous fistulas.

In the U.S., patients with end-stage kidney disease typically undergo hemodialysis via an arteriovenous fistula. This approach remains limited, however, because of the frequent development of a stenosis in the fistula circuit; although these stenoses can be treated with balloon angioplasty, recurrence rates are >50%. One promising approach to reducing restenosis after vascular interventions is the use of drug-coated balloons (DCBs; generally using paclitaxel), but their benefits in patients with stenotic dialysis fistulas is unproven. To test this approach, investigators performed an industry-sponsored, multicenter trial (NCT03041467) in 330 patients with nonstented lesions ≤100 mm in length in an arteriovenous dialysis fistula.

After succes…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)